Can negative cardiac effect of proton pump inhibitor and high-dose H2-blocker have clinical influence on patients with stable angina?

Tanaka, Shinichiro; Nishigaki, Kazuhiko; Ojio, Shinsuke; Okubo, Munenori; Yasuda, Shinji; Ishihara, Yoshiyuki; Kubota, Tomoki; Takasugi, Nobuhiro; Kawamura, Itta; Yamaki, Takashi; Ushikoshi, Hiroaki; Aoyama, Takuma; Kawasaki, Masanori; Takemura, Genzou; Minatoguchi, Shinya

doi:10.1016/j.jjcc.2008.05.004

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Using echocardiography, Schillinger et al did not observe any effect of high doses of intravenous pantoprazole on left ventricular ejection fraction or several hemodynamic parameters in healthy volunteers [22]. On the other hand, Tanaka et al showed that chronic administration of PPIs in patients with stable angina could be associated with a decrease in ejection fraction and an increase in end-systolic volume index [23]. …”

Section: Discussionmentioning

confidence: 99%

Use of Proton-Pump Inhibitors Predicts Heart Failure and Death in Patients with Coronary Artery Disease

et al. 2017

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ObjectivesProton-pump inhibitors (PPIs) seem to increase the incidence of cardiovascular events in patients with coronary artery disease (CAD), mainly in those using clopidogrel. We analysed the impact of PPIs on the prognosis of patients with stable CAD.MethodsWe followed 706 patients with CAD. Primary outcome was the combination of secondary outcomes. Secondary outcomes were 1) acute ischaemic events (any acute coronary syndrome, stroke, or transient ischaemic attack) and 2) heart failure (HF) or death.ResultsPatients on PPIs were older [62.0 (53.0–73.0) vs. 58.0 (50.0–70.0) years; p = 0.003] and had a more frequent history of stroke (4.9% vs. 1.1%; p = 0.004) than those from the non-PPI group, and presented no differences in any other clinical variable, including cardiovascular risk factors, ejection fraction, and therapy with aspirin and clopidogrel. Follow-up was 2.2±0.99 years. Seventy-eight patients met the primary outcome, 53 developed acute ischaemic events, and 33 HF or death. PPI use was an independent predictor of the primary outcome [hazard ratio (HR) = 2.281 (1.244–4.183); p = 0.008], along with hypertension, body-mass index, glomerular filtration rate, atrial fibrillation, and nitrate use. PPI use was also an independent predictor of HF/death [HR = 5.713 (1.628–20.043); p = 0.007], but not of acute ischaemic events. A propensity score showed similar results.ConclusionsIn patients with CAD, PPI use is independently associated with an increased incidence of HF and death but not with a high rate of acute ischaemic events. Further studies are needed to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Use of Proton-Pump Inhibitors Predicts Heart Failure and Death in Patients with Coronary Artery Disease

et al. 2017

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“…Proton pump inhibitor (PPI) and H 2 antagonists are recommended for the prevention of nonsteroidal antiinflammatory drugs (NSAIDs)-related ulcer. (4) However, long-term H 2 antagonist medication produces a reduction in antisecretory efficacy or tolerance. (5,6) We have previously reported that patients receiving H 2 antagonists for more than 4 weeks show resistance to preanesthetic H 2 antagonist treatment, used for acid aspiration pneumonia prophylaxis.…”

Section: Introductionmentioning

confidence: 99%

A marked increase in gastric fluid volume during cardiopulmonary bypass

Hirota

Kudo

Hashimoto

et al. 2011

J. Clin. Biochem. Nutr.

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Major physiological stress occurs during cardiac surgery with cardiopulmonary bypass. This is related to hypothermia and artificial organ perfusion. Thus, serious gastrointestinal complications, particularly upper gastrointestinal bleeding, sometimes follow cardiac surgery. We have compared the antisecretory effects of a preanesthetic H2 antagonist (roxatidine, cardiopulmonary bypass-H2 group, n = 15) and a proton pump inhibitor (rabeprazole, cardiopulmonary bypass-PPI group, n = 15) in patients undergoing cardiac surgery with cardiopulmonary bypass, and also compared in patients undergoing a off-pump coronary artery bypass graft surgery (off-pump cardiopulmonary bypass-H2 group, n = 15). Gastric pH (5.14 ± 0.61) and gastric fluid volume (13.2 ± 2.4 mL) at the end of surgery in off-pump cardiopulmonary bypass-H2 groups was significantly lower and higher than those in both cardiopulmonary bypass-H2 (6.25 ± 0.54, 51.3 ± 8.0 mL) and cardiopulmonary bypass-PPI (7.29 ± 0.13, 63.5 ± 14.8 mL) groups, respectively although those variables did not differ between groups after the induction of anesthesia. Plasma gastrin (142 ± 7 pg/mL) at the end of surgery and maximal blood lactate levels (1.50 ± 0.61 mM) in off-pump cardiopulmonary bypass-H2 group were also significantly lower than those in both cardiopulmonary bypass-H2 (455 ± 96 pg/mL, 3.97 ± 0.80 mM) and cardiopulmonary bypass-PPI (525 ± 27 pg/mL, 3.15 ± 0.44 mM) groups, respectively. In addition, there was a significant correlation between gastric fluid volume and maximal blood lactate (r = 0.596). In conclusion, cardiopulmonary bypass may cause an increase in gastric fluid volume which neither H2 antagonist nor PPI suppresses. A significant correlation between gastric fluid volume and maximal blood lactate suggests that gastric fluid volume may predict degree of gastrointestinal tract hypoperfusion.

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“…Several drugs are presently available for the prevention of thrombus. Aspirin reduces coronary thrombosis in patients with an elevated platelet count and cardiovascular risk factors [2]. Hydroxyurea is effective for preventing thrombus in patients with ET who are at high risk for thrombotic complications.…”

Section: Introductionmentioning

confidence: 99%

Acute coronary syndrome associated with essential thrombocythemia

Kumagai

Mitsutake

Miura

et al. 2009

Journal of Cardiology

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Although essential thrombocythemia (ET) has been rarely reported to cause coronary thrombosis, its appropriate management is still undefined. We describe a case of acute coronary syndrome in a patient with ET. A 47-year-old woman with ET complained of severe acute chest pain. Primary coronary angiography showed severe stenosis with thrombus in the proximal left anterior descending coronary artery. The patient was treated with anti-platelet drugs and hydroxyurea to prevent in-stent thrombosis, and subsequently underwent successful coronary angioplasty using aspiration and a distal protection device without thrombotic coronary complications.

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Can negative cardiac effect of proton pump inhibitor and high-dose H2-blocker have clinical influence on patients with stable angina?

Abstract: In this study, PPI and high-dose H2-blocker have EF-reducing tendency. However, these changes were small and these drugs seemed to exhibit little influence clinically.

Cited by 4 publications

References 13 publications

Use of Proton-Pump Inhibitors Predicts Heart Failure and Death in Patients with Coronary Artery Disease

Use of Proton-Pump Inhibitors Predicts Heart Failure and Death in Patients with Coronary Artery Disease

A marked increase in gastric fluid volume during cardiopulmonary bypass

Acute coronary syndrome associated with essential thrombocythemia

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